Contact dermatitis to topical medicaments: A retrospective study from a medical center in Taiwan

Contact Dermatitis to Ophthalmic Solutions: An Update

Eyelid and periorbital dermatitis remains a distressing and recalcitrant disease. Contact dermatitis remains the most common cause of eyelid and periorbital dermatitis. Ophthalmic solutions used in the treatment of ophthalmic conditions can often be the cause. This article is an update of our previous study, summarizing the contact allergens involved and the new test concentrations reported to investigate through patch testing. New insights found during the review are also documented.

Risk Factors of Ixekizumab-Induced Injection Site Reactions in Patients with Psoriatic Diseases: Report from a Single Medical Center

Ixekizumab (Taltz^®) is a humanized anti-IL-17A monoclonal antibody approved for the treatment of various inflammatory diseases including psoriasis and psoriatic arthritis. Despite the favorable efficacy and safety, ixekizumab is also known for its high incidence of injection site reactions (ISRs), ranging from 6% to 55% in different studies according to different definitions and studied population. However, specific risk factors for ixekizumab-induced injection site reactions in patients with psoriatic diseases had not been well studied. In this retrospective study, we found that overweight or obesity might be a protective predictor for the occurrence of ixekizumab-induced ISRs in patients with psoriatic disease. Meanwhile, having a positive family history of psoriasis might be a potential risk factor. Last but not least, patients with diarrhea following ixekizumab injection were associated with a higher risk of developing ISRs. Future high-quality studies with larger samples are warranted to verify the relationship.

Characterization of Lemon Pepper and Black Ginger Extracts and Macroemulsions as Natural Pain Relievers for Spice Stick Balsam Formulation

Lemon pepper or andaliman (Zanthoxylum acanthopodium) and black ginger (Kaempferia parviflora) are rich in bioactive compounds that possess antioxidant and anti-inflammatory activities. Our recent study demonstrated that andaliman ethanolic extract also exerted anti-arthritic and anti-inflammatory effects in arthritic mice in vivo. Therefore, natural anti-inflammatory and anti-arthritic compounds for alternative natural pain relievers in balsam formulation are needed. This study aimed to produce and characterize lemon pepper and black ginger extracts and their macroemulsion products, followed by formulation, characterization, and stability of spice stick balsam products containing lemon pepper and black ginger macroemulsions. The extraction yields obtained were 24% w/w for lemon pepper and 59% w/w for black ginger. GC/MS results showed that the lemon pepper extract contained limonene and geraniol compounds, and black ginger extract contained gingerol, shogaol, and tetramethoxyflavone compounds. Spice extracts were successfully made in the form of a stable emulsion. The antioxidant activity in both spice extracts and emulsions was relatively high (>50%). The five stick balsam formulas obtained had a pH of 5, 4.5–4.8 cm spread ability, and 30–50 s of adhesion. The stability of products showed no microbial contamination. Based on the organoleptic results, the stick balsam formula of black ginger and black ginger: lemon pepper (1:3) was the most preferred by the panelists. In conclusion, lemon pepper and black ginger extracts and macroemulsions could be used as natural pain relievers in stick balsam products to promote health protection.

Changing trends of contact allergens: A 40-year retrospective study from a referral centre in northern Taiwan

BACKGROUND

The common contact allergens may change over time as the environmental exposure changes.

OBJECTIVES

To identify the prevalence rates and changing trends of contact allergens in Taiwan over a 40-year period.

MATERIALS & METHODS

The patch testing results of a referral centre from 1978 to 2018 were retrospectively reviewed. The study population was divided into four groups according to 10-year intervals. The prevalence rates of contact sensitization to each agent and the clinical relevance were analysed. For patients with positive reactions to relevant allergens, the occupations and sites of dermatitis were analysed.

RESULTS

From 1978 to 2018, a total of 4005 patients underwent patch testing. Successively increasing trends of positive reactions to cobalt, fragrance mix I, and para-phenylenediamine (PPD) were found. Methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) was an emerging contact allergen. Hairdressers, cosmetologists, and aromatherapists became the occupations most commonly having positive reactions in the most recent 10 years. In the first two decades, the face and neck were the most commonly affected areas. Later, hands became the most commonly affected sites.

CONCLUSIONS

The prevalence rates of positive reactions to cobalt, fragrance mix I, and PPD increased successively. MCI/MI was an emerging contact allergen of special concern.

Exposure to ambient bioaerosols is associated with allergic skin diseases in Greater Taipei residents

Allergic skin diseases may result from various types of chemical and biological allergens. This study investigated the association between ambient bioaerosol exposure and allergic skin diseases by using the exposure data obtained from land use regression models and interpolated data. Data on daily average outpatient visits for atopic dermatitis (ICD-9-CM 691.8) and contact dermatitis and other eczema (ICD-9-CM 692.9) between November 2011 and August 2012 were obtained from the National Health Insurance Research Database. A generalized estimating equation was used to analyze the associations between the skin diseases and ambient bioaerosol levels. The results indicated that during the study period, contact dermatitis and other eczema were more prevalent than atopic dermatitis in the study area. Most cases were observed in districts of Taipei City and 3 major districts of New Taipei City, namely Xinzhuang, Banqiao, and Xindian. In univariate analysis, most bioaerosols were positively associated with both skin diseases. After adjustment for air pollution and sociodemographic factors, exposure to total fungal spores was significantly associated with atopic dermatitis in males (relative risk [RR] = 1.12; 95% confidence interval [CI] = 1.05-1.19). Contact dermatitis and other eczema had significant relationships with Cladosporium in males (RR = 1.07; 95% CI = 1.02-1.14) and with Aspergillus/Penicillium in females (RR = 1.04; 95% CI = 1.02-1.07). Meteorological parameters, namely wind speed, temperature, and rainfall, were also significantly associated with skin diseases. Our findings reveal that exposure to ambient bioaerosols is a significant and independent risk factor for allergic skin diseases.